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      Complications from port-a-cath system implantation in adults with malignant tumors: A 10-year single-center retrospective study

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          Abstract

          Background

          Port-A-Cath systems (PCS) are safe and convenient devices for long-term infusion in patients with malignant tumors. This study retrospectively analyzed the complications from PCS and their management.

          Methods

          Data of 1695 adults (641 males and 1054 females) with malignant tumors who underwent PCS implantation in our center from January 1, 2009 to December 31, 2019 who had complete follow-up records were collected in this study. The early and late complications and corresponding treatments were studied.

          Results

          A total of 1716 PCSs were implanted; 21 patients underwent 2 implantations each. The success rate was 100% and no severe complications occurred during implantation. The overall occurrence rate of post-implantation complications was 18.5% (318/1716); 5.5% (94/1716) were early complications and 13.0% (224/1716) were late complications. A total of 451 PCSs were removed, of which 398 were removed due to the end of chemotherapy, while 53 were removed because of complications. A total of 4 deaths occurred from these complications.

          Conclusions

          The incidence of intra- and post-operative complications is low. In most cases, complications can be effectively controlled without the removal of the PCS and regular follow-up and maintenance are critical.

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          Most cited references54

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          Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America.

          Leonard A. Mermel, Michael Allon, Emilio Bouza … (2009)
          Article 0 comments Cited 373 times – based on 0 reviews     Review now
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            Complications of central venous catheters: internal jugular versus subclavian access--a systematic review.

            Martin Tramèr, Bernhard Walder, Sibylle Ruesch (2002)
            To test whether complications happen more often with the internal jugular or the subclavian central venous approach. Systematic search (MEDLINE, Cochrane Library, EMBASE, bibliographies) up to June 30, 2000, with no language restriction. Reports on prospective comparisons of internal jugular vs. subclavian catheter insertion, with dichotomous data on complications. No valid randomized trials were found. Seventeen prospective comparative trials with data on 2,085 jugular and 2,428 subclavian catheters were analyzed. Meta-analyses were performed with relative risk (RR) and 95% confidence interval (CI), using fixed and random effects models. In six trials (2,010 catheters), there were significantly more arterial punctures with jugular catheters compared with subclavian (3.0% vs. 0.5%, RR 4.70 [95% CI, 2.05-10.77]). In six trials (1,299 catheters), there were significantly less malpositions with the jugular access (5.3% vs. 9.3%, RR 0.66 [0.44-0.99]). In three trials (707 catheters), the incidence of bloodstream infection was 8.6% with the jugular access and 4.0% with the subclavian access (RR 2.24 [0.62-8.09]). In ten trials (3,420 catheters), the incidence of hemato- or pneumothorax was 1.3% vs. 1.5% (RR 0.76 [0.43--1.33]). In four trials (899), the incidence of vessel occlusion was 0% vs. 1.2% (RR 0.29 [0.07-1.33]). There are more arterial punctures but less catheter malpositions with the internal jugular compared with the subclavian access. There is no evidence of any difference in the incidence of hemato- or pneumothorax and vessel occlusion. Data on bloodstream infection are scarce. These data are from nonrandomized studies; selection bias cannot be ruled out. In terms of risk, the data most likely represent a best case scenario. For rational decision-making, randomized trials are needed.
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              Guidelines for the management of intravascular catheter-related infections.

              , , Robert Sherertz … (2001)
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                Author and article information

                Contributors
                Jian Kong
                Journal
                Journal ID (nlm-ta): J Interv Med
                Journal ID (iso-abbrev): J Interv Med
                Title: Journal of Interventional Medicine
                Publisher: Shanghai Journal of Interventional Radiology Press
                ISSN (Print): 2096-3602
                ISSN (Electronic): 2590-0293
                Publication date PMC-release: 09 December 2021
                Publication date Collection: February 2022
                Publication date (Electronic): 09 December 2021
                Volume: 5
                Issue: 1
                Pages: 15-22
                Affiliations
                [1]Department of Interventional Radiology, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, China
                Author notes
                [∗ ]Corresponding author. Department of Interventional Radiology, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University, First Affiliated Hospital of Southern University of Science and Technology), No. 1017, Dongmen Bei Road, Shenzhen, 518020, China. Kongjian@ 123456mail.sustech.edu.cn
                [1]

                These authors contributed equally to this work and are co-first authors.

                Article
                Publisher Item ID: S2096-3602(21)00070-3
                DOI: 10.1016/j.jimed.2021.12.002
                PMC ID: 8947993
                PubMed ID: 35586285
                SO-VID: e1ac272b-c752-4753-a1bd-6507045fbcea
                Copyright © © 2021 Shanghai Journal of Interventional Radiology Press. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 6 September 2021
                Date revision received : 30 November 2021
                Date accepted : 8 December 2021
                Categories
                Subject: Article

                Keywords: port-a-cath system (pcs),complications,treatments
                Data availability:
                Keywords: port-a-cath system (pcs), complications, treatments

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